ACUPUNCTURE AND SNAIL SHELL
MOXIBUSTION IN THE TREATMENT OF EYE DISEASES Part 1

by Shmuel Halevi Ph.D

Originally published in the Journal of Chinese Medicine in England.

The forty year old man who came to my office at the beginning of June 1994 seemed
desperate. He was a police captain with no previous health problems. His job was very
demanding, and for many years he had spent most of his time at work. Two weeks preceding
our appointment, Mr. A (the patient) had a terrible quarrel with his superiors, after
which he immediately felt intense heat rushing up to his head. Right after this he
experienced a flash-like sensation in his left eye, followed by a stabbing pain inside the
eye and loss of vision.

Alarmed and in pain he went to see the police physician who referred him to an eye
specialist at a nearby hospital. Pictures of the fundus of the eye were taken, and the
diagnosis was severe rupture of blood capillaries, causing internal hemorrhage and
accumulation of blood which prevented vision. The specialist suggested a laser operation
in order to repair the ruptured capillaries. This could only be performed after the blood
had been reabsorbed, which would probably take at least six months. Thus, seeing only
blurs with his left eye, and with such a depressing prognosis, Mr. A fell into a state of
severe depression, fear and anxiety.

When I examined him on his first visit his pulse was slightly fast (around 6 beats per
respiration), the left cun position was slightly elevated, hard and tense, his left guan
position was strong and wiry, and the chi (Kidney) position on both wrists was deep and
barely palpable. His tongue was pale, lifeless and had a blue-purplish hue. Both inner
eyelids had red-purple blood congestion stains.

Suspecting a tendency to sudden flaring up of Liver yang based on some Kidney yin
deficiency, I questioned Mr. A who admitted that on occasions, especially when he became
irritated, he felt that his entire head heated up and began to perspire. Thus, a fast and
wiry pulse in the Heart and Liver positions indicated Liver qi stagnation, resulting in
ascending yang which speeded up heart rate and pushed blood towards the head. The trauma
to his eye happened as a result of a sudden and intense rage which had set the mechanism
described above into motion. This was presumably the "last straw" for already
weakened capillaries. This picture is supported by the observation of the blood congestion
pattern within the inner lid. As in most cases of this pattern, the foundation is Kidney
deficiency, in this case weakened by many strained working hours over many years.
Additional signs such as occasional lower back pain, tenderness at left Jingmen GB-25, and
a distended lower abdomen all confirmed this observation. If combined with very strenuous
working conditions and anger (he was a police-officer), this may put into motion the Liver
yang activity that further exhausts Kidney yin, making a vicious circle that is bound to
end in a crisis. The reason why this accident had happened in the left eye, rather than in
the right, was because in the majority of acute crises, where yang qi abundance, or
excessive yang movement is the cause, the left side is more likely to be affected. This is
stated in the classics "... all the yang qi goes to the left, while the yin qi goes
to the right ...". My first treatment was designed to calm the patient, relieve his
anxiety and relax his tension. I therefore assured him that with Chinese medicine his
prognosis was very favorable, and that he should refrain from heating foods (spices,
coffee, alcohol, etc.), take a month's vacation and come for daily treatments. I then
needled the following points:

Taichong LIV-3, Baihui DU-20 and Sanyinjiao SP-6 is also a renowned and
efficient formula to sedate the Liver, subdue its yang, and assist in calming the Heart.

Taiyang (Extra) and Guangming GB-37 were chosen to treat the left eye.
The combination of these points, one local and one distal, is able to reduce heat,
circulate qi in the eye and brighten the eye.

Taiyang (Extra), Taichong LIV-3, and Guangming GB-37 together are able to
resolve qi stagnation via the Liver system. The combination of Taichong LIV-3 and Guangming
GB-37 is based on the principle of combining the Yuan-Source point on the primarily
affected channel with the Luo-Connecting point of its interiorly-exteriorly paired
channel.

All points were manipulated by reducing technique i.e. counter clockwise rotation,
forceful lifting and slow thrusting the needles on the extremities were directed against
the direction of flow of energy in the channels.

In less than 10 minutes Mr. A reported that he felt very sleepy and that he had a
comfortable feeling in his left eye. The needles were removed after 30 minutes and he was
asked to come back the next day when his pulse rate was only five beats per respiratory
cycle, and his left cun and guan positions had lost their hard and wiry quality. He
reported that he had slept heavily for ten hours that night, and that his mood and overall
feeling had radically improved.

Mr. A's second treatment began with left Fengchi GB-20 point, maneuvered first by
dispersing technique, then immediately followed by the "Dragon Wags its Tail"
technique which is effective to move qi rather forcefully. The handle of the needle is
wagged to and fro with one hand while the other hand massages the channel in the direction
chosen to propagate the sensation. Thus, Mr. A felt the needle sensation climbing up his
skull and ending deep in his left eye. In subsequent treatments, however, there was no
need to massage the channel route. Maneuvering the needle at Fengchi GB-20 was enough to
cause the same effect. As soon as the needle sensation reached the left eye (usually after
10 to 15 seconds), the patient was asked to lie supine with the Fengchi GB-20 needle in
situ (and with a pillow to support the head). The other points were then punctured in the
following order (all on the left side):

Hegu L.I.-4

Quchi L.I.-11

Taiyang (Extra)

Qiuhou (Extra) to be alternated every other

treatment with Chengqi ST-1

Zusanli ST-36

Taichong LIV-3 bilaterally

Guangming GB-37

Hegu L.I.-4, Quchi L.I.-11, Chengqi ST-1 and Zusanli ST-36 form a chain
of points situated on the left hand and leg yangming channel. This channel has an
abundance of qi and blood, and is therefore usually used to resolve stagnation and
accumulation of qi and blood. Moreover, all of these points have a strong effect on
disorders of the head region.

This point prescription was aimed at forcefully moving qi and blood via the yangming
channel in the left portion of the hand in general, and in the left eye in particular. In
addition, the Liver as the main cause of the disorder had to be further sedated, utilising
points that have an effect both on the Liver and the eye. After obtaining deqi, all the
points on yangming channel were manipulated in the same fashion as Fengchi GB-20. Hegu
L.I.-4, Quchi L.I.-11 and Zusanli ST-36 were very responsive, and always gave
rise to a distinct sensation traveling proximally and terminating around or inside the
left eye. While Zusanli ST-36 was manipulated, Mr. A could track the flow of sensation
across his thigh, abdomen and chest, and usually pointed with his right finger to Touwei
ST-8 as the last station of the traveling sensation. Guangming GB-37 was
manipulated by the same technique. Taiyang (Extra) was manipulated by simple
lifting-thrusting with small amplitude movements, and initially gave a sensation of a deep
stabbing sensation inside the eye, which subsequently changed to round waves encircling
the inside of the eye. For Chengqi ST-1 and Qiuhou (Extra), the patient was
asked to roll his eyeballs upwards and the needles were quickly inserted to a depth of
approximately 1 cun, until a pressure was felt behind the eye. All points were left in
situ for 30 minutes each time.

At the end of a course of ten treatments (12 days), Mr. A could read freely, except for
very small letters, and could drive his car. He regained his confidence, slept well and
enjoyed his enforced vacation. Nevertheless, he could not differentiate colors at this
stage. Even though he experienced remarkable deqi with needling, I decided at this point
to apply moxa to his eye in order to promote blood and fluid dispersion within the eye in
a more vigorous way. Some years ago I read about a renowned Chinese physician who used an
empty walnut shell, soaked in herbal tea, as a heating device (with moxa) to treat eye I
disorders. I devised my own version by utilising for the same purpose an empty and
sterilized snail shell of approximately the size of a human eye. A snail shell has some
unique qualities, which make it superior, in my opinion, to a walnut shell. It conveys
heat in a very moderate and tolerable way, is quite resistant to intense heat and does not
crack easily. Its conch-like shape allows the heat, stemming from its top, to concentrate
and conduct itself through the inner tunnel, until it reaches and penetrates the eye.
Another feature of this shell may be an ability to soothe and descend Liver yang. Even
though, as far as I know, snail shell is not a substance used in the Chinese materia
medica, it resembles in shape and quality other substances which are. Substances such as Shi
Jue Ming (Concha Haliotidis), Zhen Zhu (Margarita) and Mu Li (Concha
Ostreae) are all known for their ability to subdue Liver yang, and many of them are
used specifically for eye diseases associated with Liver yang disturbance. Assuming that
substances similar in shape and construction usually bear parallel energetic qualities, it
was reasonable to expect promising results. Thus, 10 minutes after needles were inserted
at Taiyang (Extra) and Chengqi ST-1, I withdrew the needles, and laid the
snail shell over the left eye, covering the whole eye region, and pressing gently against
the skin. Over the top of the shell I ignited a moxa cone the size of one cubic
centimeter, and let it burn to the end. This procedure was repeated three times in each
session. The outcome of this technique was quite remarkable. Mr. A reported an
extraordinary feeling and movement engulfing his eye, giving him a relaxed and pleasant
sensation that he had never experienced before. Right after the first session his colour
differentiation improved, and his eyesight brightened even more. After two more sessions
with the snail moxibustion he was able to distinguish colors normally.

Snail shell application with a moxa cone.

This treatment was
continued twice a week, substituting Jingming BL-1 for Chengqi ST- 2. This
was done in order to enhance fluid absorption in the eye fundus. Jingming BL-1,
being the last point of the Yin Qiao Mai, is capable of absorbing excessive yin around the
eye. Thus, it is often used to treat somnolence, excessive lacrimation, glaucoma, etc. In
addition, and in order to affect this goal even more radically, Zhaohai KID-6,
being the master and first point of the Yin Qiao Mai, was occasionally punctured
bilaterally. Mr. A was discharged after 20 treatments, and had regained his eyesight
almost as it was before the accident.